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What Is VA Form 10-3542?
VA Form 10-3542, Veteran/Beneficiary Claim for Reimbursement of Travel Expenses is a document submitted to the Department of Veterans Affairs (VA) by the veteran or beneficiary to cover trip expenses for getting professional medical help in another state or country.
The latest version of the form was released on
November 1, 2013 , with all previous editions obsolete. An up-to-date VA Form 10-3542 fillable version is available for
download below and can be found through the VA website.
If you are a veteran or beneficiary receiving a VA pension or if your income is lower than the pension, you are entitled to a travel compensation.
The purpose of the travel eligible for reimbursement must be linked to your condition, treatment, or service. Costs are reimbursed within thirty days after the travel.
To be considered eligible, the claimant has to belong to one of the following categories:
- Veterans with a disability rating of 30% or more may be reimbursed for travel-related to any healthcare condition;
- Veterans with a disability rating of 30% or less may be reimbursed for travel related to their service-connected condition;
- Veterans receiving VA pension benefits may be reimbursed for travel-related to any condition;
- Veterans with an annual income below the maximum allowed annual rate of pension may be reimbursed for travel-related to any condition;
- Veterans who are unable to defray the cost of travel (as defined in current Beneficiary Travel regulations);
- Veterans traveling in relation to a Compensation and Pension (C&P) examination;
- Beneficiaries of other Federal Agencies authorized by that agency;
- Allied beneficiaries when authorized by the appropriate foreign government agency;
- Certain non-veterans (caregivers to veterans under the National Caregivers Program, medically required attendants, VA transplant care donor and support person, or other claimants subject to current regulatory guidelines).
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VA Form 10-3542 Instructions
The form is completed by a veteran-claimant or their representative. Allied beneficiaries and beneficiaries of other federal agencies do not have to complete Section A, Question 3a-c regarding the veteran's full name, social security number, and date of birth.
Receipts are required for the following expenses: non-mileage expenses, including bridge, road and tunnel tolls, as well as parking, ferry fares, meals and lodging, transport by bus, train, taxi or other public transportation. Meals and lodging require prior approval.
The claim will be evaluated to determine eligibility for travel benefits and services. If it is determined eligible, it will be processed for payment at a currently authorized rate subject to any required deductibles.
The VA Form 10-3542 is distributed with filling guidelines provided in the second page of the form. Step-by-step instructions can be found below.
How to Fill Out VA Form 10-3542?
The VA 10-3542 must be completed with the following details:
- Section A requires information about the traveler. The claimant's full name, date of birth, social security number, and status must be provided. It is recommended to use a passport or ID card to enter correct details, as given in official documents. The form requires the veteran's name, social security number, and date of birth;
- Section B is for providing data about the travel. The date, time of the trip with the departure and arrival addresses should be submitted. To avoid making mistakes, a claimant should prepare the tickets and other documents containing this information;
- If an individual is going to apply for additional reimbursement, they have to enlist all the items they want to receive compensation for, such as tolls, parking, lodging, meals, etc. A claimant must be ready to provide the receipt for each item they want to be reimbursed for. The name of treating facility and its address must be provided, which may be a VA- or non-VA treating clinic;
- Section C is for the certification. The claimant states that they have provided true-to-life and up-to-date information and have incurred a cost in relation to the travel claimed; has not obtained transportation at government expense, through the use of government-owned conveyance, or government purchased tickets or tokens or received other transportation resources at no cost to them. Also, the claimant has to certify that they have never received any veteran trip compensation before, and they are the only person claiming for the travel listed. When signing the form the claimant must be aware of their full responsibility for the provided data. Providing false, fictitious, or fraudulent details leads to severe criminal and civil penalties including fine or imprisonment, or both.
Where Do I Send My VA Form 10-3542?
The form may be presented in person or mailed to the VA health care facility where this care was provided. An up-to-date VA facility locator tool allows an individual to search for the nearest VA medical center, as well as other health facilities, benefits offices, cemeteries, and Vet Centers within 1925 VA facilities. This storehouse of facility and key staff information within VA facilities is maintained on a regular basis throughout the VA network, is designed for ease-of-use and categorizes information for browsing by state and administration. The addresses of all VA health care facilities can be found on the VA website.
Where to Fax VA Form 10-3542?
One of the methods to apply for travel reimbursement is to send the VA travel form 10-3542 via secure fax or mail to the local Beneficiary Travel Office. Contact information, including phone numbers and fax numbers of VA health care facilities, can be found at the VA website.